Individual
GREGG S. BOLOTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
751 MEDICAL CENTER CT, CHULA VISTA, CA 91911-6617
(619) 482-5825
Mailing address
2100 POWELL ST, SUITE 900, EMERYVILLE, CA 94608-1826
(510) 350-2600
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G70468
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G704680
—
CA
Enumeration date
08/05/2006
Last updated
09/12/2007
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